Heart failure & cardiomyopathies

Vagal Nerve Stimulation in Patients With Heart Failure and Reduced Ejection Fraction: The ANTHEM-HFrEF Trial

J Am Coll CardiolPublished Randomised controlled trial

Authors' conclusion

The underpowered primary endpoint was neutral. Data documented feasibility, safety, and autonomic engagement. Trends favoring outcomes, symptoms, and function were inconclusive although hypothesis-generating.

Study context

Population
HFrEF, NYHA class II or III, left ventricular ejection fraction (LVEF) ≤35%, NT-proBNP ≥800 pg/mLenrollment terminated early
Participants
532 participants
Comparison
Vagal nerve stimulation (VNS) vs control
Primary endpoint
Time to CV death or HF hospitalization
Methodological details2:1 randomisation, adaptive sample sizing
  • 2:1 randomisation
  • Adaptive sample sizing

Primary result

As reported in the abstract

Primary efficacy endpoint not met

HR: 0.84; 95% CI: 0.62-1.12

P = 0.115

Secondary outcomes

Heart failure (HF) hospitalization, KCCQ, NYHA class, 6-minute walk distance

Favorable, although inconclusive

LVEF

Unchanged

Exploratory outcomes-symptoms win ratio (prespecified)

Favorable but hypothesis-generating; marginal statistical significance

Safety

Freedom from procedure- or device-related serious adverse events (primary safety endpoint)

Freedom from procedure- or device-related SAEs
96.7%

Original publication

Vagal Nerve Stimulation in Patients With Heart Failure and Reduced Ejection Fraction: The ANTHEM-HFrEF Trial. J Am Coll Cardiol. Published 20 May 2026. doi:10.1016/j.jacc.2026.03.040

Composed by AI from the published abstract and checked against it. How Briefs are made →

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